How To Prevent Antibiotic-Associated Diarrhea
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Horses sometimes need to be treated with antibiotics. That's an unavoidable fact. Some horses that are treated with antibiotics develop diarrhea, which can be fatal. That's another unavoidable fact. While those two situations can't be avoided, the risks can be decreased.
Addressing the first point, "sometimes horses need to be treated with antibiotics," involves various factors such as having a good preventive medicine program, good infection control and only using antibiotics when they are truly needed. We'll never absolutely eliminate the need for antibiotics, but we can reduce their use.
The second point is a little harder to address. Any horse being treated with antibiotics is at some risk of developing antibiotic-associated diarrhea. In addition to hopefully killing or inhibiting the bacteria at the site of the infection, antibiotics also reach the intestinal tract, where there can have effects on the complex resident bacterial population. Disruption of this normal bacterial population can allow "bad" bacteria to overgrow, resulting in diarrhea. How do we reduce the risk?
- Use antibiotics only when necessary and with the advice of your veterinarian.
- Avoid high-risk antibiotics (e.g. tetracyclines, erythromycin in adult horses) unless absolutely required.
- Use local (i.e. topical) therapy whenever possible instead or oral, intravenous or intramuscular administration. This limits the amount of antibiotic that makes it to the intestinal tract.
- Try to minimize other potential risk factors for diarrhea such as diet changes, high grain diets, transportation and other stresses.
- Monitor your horse closely and contact your vet if there are any signs of colic or diarrhea.
- It might be reasonable to avoid anti-ulcer drugs, since it's possible there could be increased risk of diarrhea while being treated with these drugs (possible, but not proven).
Probiotics are often used, but there is currently no evidence they are effective in horses. Mixed results have been obtained in people. It's possible that certain probiotic organisms at certain doses may help reduce the risk of certain types of diarrhea in certain horses. We just don't know what "certain" means at this point. Probiotics probably won't hurt, but we can't have any confidence in them yet that they are really beneficial. No other supplements have been shown to be effective, and there is little reason to suspect that any would be effective.
